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一项全国性队列研究表明,幼儿期接受全身麻醉与发育迟缓风险增加有关。

A National Population Cohort Study Showed That Exposure to General Anesthesia in Early Childhood Is Associated with an Increase in the Risk of Developmental Delay.

作者信息

Yang Ya-Ling, Wang Liang-Jen, Chang Jung-Chan, Ho Shu-Chen, Kuo Ho-Chang

机构信息

Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 883, Taiwan.

Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.

出版信息

Children (Basel). 2021 Sep 24;8(10):840. doi: 10.3390/children8100840.

Abstract

This study investigated the relationship between exposure to general anesthesia (GA) and the risk of cognitive and mental disorders. This study has thus investigated the relationships between exposure to GA before the age of 3 and subsequent cognitive and mental disorders in a national-wide research sample. We obtained our subjects from the National Health Insurance Research Database (NHIRD) of Taiwan, which was based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Children in the hospital aged less than 3 years old were included if there was GA exposure or not during the period of year 1997 to 2008. Cox proportional hazard regression models adjusted for potential confounding factors were used to estimate the relative magnitude of the risk associated with GA exposure. The cohort contained 2261 subjects with GA and 4522 children without GA as a comparison group. GA exposure group had a higher rate of developmental delay than in the without GA group (hazard ratio 1.46, < 0.0001). There was no significant difference in the overall incidence of ADHD, autism and intellectual disability between the GA-exposed group and the comparison cohort. In conclusion, this study reported that children exposed to GA early before the age of three had a small association with increased risk of development delay thereafter.

摘要

本研究调查了全身麻醉(GA)暴露与认知和精神障碍风险之间的关系。因此,本研究在全国范围内的研究样本中,调查了3岁前暴露于GA与随后的认知和精神障碍之间的关系。我们从台湾国民健康保险研究数据库(NHIRD)中选取研究对象,该数据库基于《国际疾病分类,第九版,临床修订本》(ICD - 9 - CM)。纳入1997年至2008年期间医院里年龄小于3岁的儿童,无论其是否有GA暴露。使用针对潜在混杂因素进行调整的Cox比例风险回归模型来估计与GA暴露相关的风险的相对大小。该队列包含2261名有GA暴露的受试者和4522名无GA暴露的儿童作为对照组。GA暴露组的发育迟缓发生率高于无GA暴露组(风险比1.46,<0.0001)。GA暴露组与对照组在注意力缺陷多动障碍、自闭症和智力残疾的总体发病率上无显著差异。总之,本研究报告称,3岁前早期暴露于GA的儿童与随后发育迟缓风险增加之间存在较小的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bb7/8534755/b9e9e2bce629/children-08-00840-g001.jpg

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